27 June 2017

Oxford PharmaGenesis recently attended the 22nd Annual International Meeting of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) held in Boston, MA, USA on 20–24 May 2017. A wide variety of stakeholders in market access and health economics and outcomes research (HEOR) were in attendance, from the pharmaceutical industry, government agencies and academia, as well as more than 100 exhibitors representing research and communications consultancies.

The conference provided an excellent opportunity to reconnect with clients and former colleagues from industry, and to come up to speed on some of the hot topics in HEOR and market access.

Major themes

The primary theme of this year’s international meeting was ‘Evidence and value in a time of social and policy change’. The first plenary session centred on US health policy change and uncertainty, with panellists expressing concern over the perceived instability of the US healthcare market, and its implications for healthcare systems, worldwide.

The second plenary session addressed the role of social interactions and social networking in health outcomes and treatment. Dr Nicholas Christakis presented data and discussion points on how to build effective interventions that utilize social influence to improve individual and population-level health and wellness.

The third and final plenary session focused on the ever-increasing role of effectiveness research in medical decision-making, challenging the audience and research community to re-think the primacy of randomized controlled trial data and to consider how the increasing availability of linked electronic medical records and big data has and will continue to change the value of HEOR.

Reconsidering value frameworks

A number of panel discussions and break-out sessions focused on value frameworks and their impact on the consistency of the evidence that payers consider when evaluating healthcare interventions. This is a timely topic in the USA, because a host of organizations (e.g. the American Society for Clinical Oncology, the National Comprehensive Cancer Network, Memorial Sloan-Kettering Cancer Center, Premera Blue Cross) are developing their own value frameworks, challenging the quality-adjusted life-year and other measures based on incremental cost-effectiveness ratio thresholds.

Specifically, ISPOR has established a special taskforce to develop its own value framework, which is outlined in a recent white paper. During one of the focal sessions of the conference, members of the taskforce led a review and discussion of the paper, highlighting the paper’s recommendations to ensure that value is captured from the perspective of both the patient and the payer and that consideration is given to the broader implications of healthcare audiences outside of the USA. Panellists stressed the need for a greater emphasis on patient preferences and the patient perspective in value frameworks.

A recurrent comment throughout these value framework-focused sessions was that, in economic terms, value implies that there will be trade-offs and a recognition of opportunity costs. However, without empirical estimates of opportunity cost and consistent use of cost-effectiveness thresholds, are we really talking about a value framework or are we simply developing scoring systems that do not directly impact decision-making?

ISPOR: leadership in HEOR excellence and the evolution of value demonstration

As ISPOR President Lou Garrison remarked at the opening of the conference, “post-launch data is a public good that is currently underserved by both public and private entities.” In keeping with this sentiment, ISPOR has worked consistently to raise the profile and standard of HEOR and real-world data, and continues to play a vital role in facilitating dialogue between HEOR researchers, healthcare decision-makers and the pharmaceutical industry. We at Oxford PharmaGenesis are delighted to have had the opportunity to exhibit and take part in this important conference.